Retinal Manifestations in Hematological Disorders

Red blood cell, white blood cell, and platelet disorders often lead to a large variety of hematologic effects in ocular tissues, and especially in the retina. Although retinal findings may not be pathognomonic of a specific blood disorder, ophthalmologists can directly visualize characteristic retinal changes and be the first to diagnose a blood dyscrasia. Typical findings on indirect ophthalmoscopy are retinal hemorrhages, microaneurysms, hard exudates, cotton wool spots, macular edema, retinal vascular edema, pallor of the disc, edema of the disc, retinal and optic disc neovascularization, vitreous hemorrhage and inflammation, retinal and retinal pigment epithelium detachment, and retinal and choroidal infiltrates. Other retinal findings may be more indicative of a specific blood disorder, such as thalassemia or sickle cell disease. High-resolution imaging can help ophthalmologists in the detection of early retinal changes or more peculiar findings and can guide physicians in an early diagnosis of a specific blood dyscrasia.